JPS59183734A - Otoscope and audiometer - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates generally to medical diagnostic equipment, and more particularly to a novel audiometer incorporated into a hand belt otoscope.

Hand belt otoscopes of the medical and surgical type are well known in the prior art. Audiometers for testing hearing loss are also well known. Traditional audiometers have been hand-belt devices, relatively large tabletop units that use Ear 7 on when testing patients. Additionally, conventional audio equipment was typically installed in a silent room to minimize noise with low ambient noise.

The only easily portable hand belt audiometer known to applicants is disclosed in US Pat. No. 3,105,876. This device is not dual-purpose like the present invention, but only operates as a hearing test, checking a patient's hearing at different frequencies and different sound intensity levels, but it inconveniently requires a dial. Since the frequency is changed by moving the device, the operation itself generates noise, which can mislead the patient. Another disadvantage of this device is that the lengths of the audio frequency signals must be exactly equal and precise to obtain correct results, but are under operator control.

Before testing a patient's hearing, the ear canal must be visually inspected for an unobstructed passage to the eardrum. This is to prevent diagnostic errors from occurring due to earwax or other obstructions. When using conventional audiometry equipment, this visual test requires a separate instrument, such as a conventional otoscope, which is not always performed. By using the combined Nordbelt device of the present invention, an initial vision test and a hearing test can be performed with the same device without removing the device's otoscope from the patient's ear.

The otoscope and audiometer according to the invention is equipped with conventional illumination means and an unobstructed viewing path for visually inspecting a patient's auditory canal. The device is further provided with means for transmitting tones of different frequencies to the patient's ears and calibrated electronic circuitry for automatically generating tones of different frequencies in sequence. The electronic circuitry also includes timing means to precisely control the length of each tone; the tone generation and its length are not controlled by the operator.

The outer surface of the otoscope and audiometer is provided with an indicator, preferably a light emitting diode, to indicate when each tone is delivered to the patient's ear. Additionally, the device includes a control switch, a "ready" indicator and an undervoltage indicator (preferably a rechargeable battery).
has.

Next, please refer to the attached drawings. 1-3, the otoscope and audiometer essentially consists of an elongated body or handle portion 10 and a head portion 11 having an integral otoscope 12 therein. The handle is hollow and includes a removable cover 13 that is accessible inside the handle.

The cover 13 can be removed from and attached to the rest of the handle 14 by a longitudinal sliding movement as indicated by the dotted line 13A in FIG. This cover is attached to the disc 15 of FIG.
° Rotatable) (Thus, it is always locked in the locked position.

The first scope is provided with a visible passage 16 passing through the head part 11 as usual, and this passage 16 extends from an opening 17 at the outer end of the otoscope 12 to an opening 18 at the rear of the head part. . The aperture 18 is permanently closed in a nearly hermetically sealed manner by a sealing member consisting of a frame 21 and a lens 20 of the type disclosed in commonly owned US Pat. No. 3,698,387.

The opening 17 at the outer end of the otoscope is wrapped with a preformed bundle 22 (FIG. 5) of light-transmitting optical fibers embedded in the side of the otoscope. The fiber optic bundle curves downward toward the upper end of the sleeve 24 at the upper end of the handle 10 and is cylindrical at the receiving end. The light-transmitting end of the lamp 25 is housed within the lower end of the sleeve, so that the fiber bundle receives the light from the lamp and directs it to the outer end of the otoscope, where the light is distributed in a generally annular pattern. It is emitted and illuminates the field of view. This arrangement of fiber bundles is not disclosed in commonly owned US Pat. No. 3,146,775, so the fibrillation itself is not new.

As shown in FIG. 5, the otoscope 12 in use is provided with a removable hollow tip 26. This tip 26 constitutes an extension of the viewing channel 16, protecting the fiber end at the outer end of the otoscope and separating this point from the examination area. The tip 26 has an outer end 27 of relatively soft deformable material that is rounded or spherical so that it provides a good seal between the tip and the ear canal surface, damping ambient noise and reducing leakage around the tip. This prevents a decrease in the dB level of the eardrum. An otoscope tip having such a structure is disclosed in co-pending US application Ser. No. 222,281.

Lamp 25 is preferably a 3.5 inch halogen lamp and is powered by a rechargeable battery 28 (FIG. 4). At the lower end of the handle 10 is a socket 50 (FIGS. 3 and 4) for receiving a jack connected to a conventional direct plug-in transformer (not shown). Alternatively, the device may be provided with a known charging stand (not shown), and therefore includes external charging contacts 61 (FIG. 4) for use with such a stand.

According to the invention, the otoscope and audiometer has circuit means for automatically generating sequentially four pure tones of different frequencies (FIGS. 4-6). These tones are used to determine whether a subject is hearing impaired. These circuits are mounted on two printed circuit boards 33 and 34 (
5) and is removably fixed inside the handle by a mounting screw 35. The tones generated by this circuit are generated from a transducer 36 and sent into the interior of the head 11 by an acoustic tube 37. The upper end of this tube 37 is connected to the head by an acoustic coupling 58. From inside the head, which has a predetermined volume, a tube enters the patient's auditory canal through the otoscope 12 and the tip 26.

In a preferred embodiment of the invention, the tones generated by the circuit are: 500Hz; 1. OOOOHz, 2,00
0Hz.

a, oooHz, and each sound has an accepted normal hearing threshold of 25 dB. For each tone, a visible indicator in the form of a light emitting diode is provided,
These diodes are designated 40-43 in FIGS. 3-6. In FIG. 3, the apparatus also includes an ON10FF switch 45, a start/restart switch 46, a ready indicator 47, and an undervoltage indicator 48.

Referring now to the block diagram of FIG. 6, the entire circuit is powered by a rechargeable battery 28, which is connected to the circuit by closing the 0N10FF switch. When the switch 45 is closed, the halogen lamp 25 emits light and the device can be used as an otoscope. This battery output is controlled by a voltage stabilizer 50, and a comparator circuit 51 is used to detect voltage shortage. When the battery voltage drops below a predetermined level, the indicator 48 turns on and other circuits become inactive. This is to prevent test results from becoming inaccurate due to inaccurate battery voltage.

When switch 45 is closed, a signal is generated by a precision sine wave generator 52 with a single component frequency control mechanism.

This signal is amplitude modulated by a gain controllable operational transconductance amplifier 54, which drives the transducer 36.

To use the device as an audio amplifier, press the start/restart switch 46, which causes the clock 56 to
The digital sequence circuit 55 controlled by the digital sequence circuit 55 is energized. This sequence circuit 55 controls the frequency and amplifier gain of the generator 52 and drives the tone indicators 40-43 for the different tones.

A current source type rectangular wave/triangular wave converter 57 is used to convert the control signal from the sequence circuit 55 into a ramp signal for amplitude control. Converter 57 thus operates as a timing device by precisely controlling the rise and fall times required for audio test tones. The circuit shown in FIG.
Factory calibrated to produce three levels, these levels can be adjusted by the factory technician by changing the values of some of the components, such as the frequency by adjusting the variable resistor 59, and the amplitude at each frequency by adjusting the variable resistor 59. It can be increased or decreased by adjusting the resistor 60. Alternatively, it is possible to eliminate resistor 59 and set the frequency by a digitally generated stable frequency control signal generated by a sine wave generator locked to the digital signal.

Although we mentioned above that the four tones of different frequencies are at an acceptable normal audible threshold of 25 dB, it is preferable that these tones be at higher dB levels than this, e.g. 40 dB and 60 dB, or There must be. To this end, the circuit of FIG. 6 can be modified as shown in FIG. 7 by installing a six-point selector switch 62 at both ends of the transducer.

When the switch is at the first point 63, the tone will be 25 dB, and at the second point 64 and third point 65 the tone will be 40 dB and 60 dB, respectively.

The six points on the switch determine the resistance values of resistors 66, 67 and 68 in the circuit.

The above-mentioned devices include a fully self-contained clinical otoscope and/or
or as a screening audiometer, and is also generally suitable for use by practitioners, pediatricians, otolaryngologists, or nurses in their clinics. The device works effectively under ambient noise conditions in a typical "quiet" clinic as the soft tips attenuate noise, a major improvement over standard audiometer headphones. . In highly noise-prone environments, disposable noise-attenuating ear plugs or single over-the-ear cushions can be used in the untested ear. This device can be used on patients at least 4 years old if they are responsive and cooperative.

As mentioned above, to use the dual purpose device of the present invention, it is first used as an otoscope to view and inspect the auditory canal to determine whether there is an unobstructed path to the eardrum. If there is an obstruction up to the eardrum, the sound level at the eardrum will not necessarily be accurate. This visualization allows for proper alignment of the tip within the ear canal, thereby eliminating the possibility of altering the sound level due to the tip facing the canal plane. TEP also works to widen the narrowed ear canal, which can cause attenuation of sound levels at the eardrum, allowing for accurate hearing assessment.

Naturally, if earwax is found, it must be removed by hand. The hearing test can then be started by pressing the 5TART switch 46.

Before beginning the hearing test, instruct the patient to raise and lower their fingers or make other movements when they hear the tones start and stop. The accuracy of the patient's response is determined by the tone indicator 40.
~The inspector checks by watching 45 turn on and off.

If the patient is unable to hear one or more 1-tones,
Usually referred to a specialist for a complete hearing evaluation.

Switch 46 in FIG. 6 is a start/restart switch, which reminds us that in conventional circuitry, pressing a point during a four tone sequence will start the sequence again. This may be helpful if the patient appears to be guessing.

Printed circuit boards 33 and 64, transducer 36 and acoustic W 37 are all component modules that can be easily fitted into or out of the device by removing mounting screws 35. The module is initially calibrated at the factory and can be returned to the factory if calibration is required. This can be done in a short period of time and is cheaper than calling a service. Since the modules of these devices are all identical to each other,
With the acoustic coupling 38 at the upper end of the acoustic tube in Fig. 5?
A good seal is always ensured between the coupling of , and the matching conical opening in the elastically pressed head.

Since the heads 11 of the devices are precisely molded and manufactured using the same mold, the internal cavities 16 of all devices have the same volume and shape. Due to this and because the electronic modules are uniformly calibrated, there is virtually no difference in sound level from device to device.

FIG. 8 shows a modification of the device of the present invention, in which an audiometer conversion unit 70 is installed in a standard clinical otoscope.
is incorporated, making it an otoscope and audiometer. This standard otoscope includes a battery handle 71 and a separable otoscope head 72, and the conversion unit is provided with suitable fittings 74 and 75 to engage the handle and head, respectively. The conversion unit corresponds to the body part 10 described above and includes the circuitry described above and generates four tones of different frequencies. This unit is also provided with the same switches and indicators (collectively designated 76), including an 0N10FF switch within the handle 71.

The tones generated by transducer unit 70 emanate from a transducer (not shown), such as transducer 36, which is acoustically connected to otoscope 72 by a flexible conduit 77. Conduit 77 has a fitting 78 at its outer end which is hermetically received 11 within a bore 80 in the head. The hole is a conventional fitting that connects the inflation bulb to the otoscope.

From the foregoing description, it will be apparent that the present invention provides a novel and highly advantageous medical device. In particular, a person skilled in the art will be able to easily modify the design of the present invention without departing from the gist of the present invention.

[Brief explanation of the drawing]

FIG. 1 is a side view of an otoscope and audiometer embodying the present invention, with the otoscope section cut away to show the structure, and FIG. 2 is a bottom view of the device shown in FIG. 3 is a rear view of the device shown in FIG. 1, FIG. 4 is a partial front view of the device with the cover removed to show the arrangement of internal parts, and FIG.
Longitudinal cross-sectional view of the device along line 5-5 of FIG.
7 is a partial diagram of the block diagram of FIG. 6 showing improvements in the circuit, and FIG. 8 is an exploded view showing a modification of the device of the invention. 101 main body, 11-head part 12-otoscope,
16-passage 22-optical fiber bundle, 25-lamp

Claims (1)

Claims: (1) comprising a body portion and a head portion, the rad portion having an integral otoscope, the head portion and the otoscope having an obstructive, odor-visible passageway therethrough; , further comprising means provided within the head portion for directing the light beam outward into the auditory canal under examination; means provided within the body portion for automatically generating tones of different frequencies in sequence; and means provided within the body portion for automatically generating tones of different frequencies in sequence; An otoscope and audiometer consisting of a means for feeding into the head, then passing through an otoscope and into the auditory canal. 2. An otoscope and audiometer according to claim 1, wherein the main body is a battery handle containing circuit means for generating tones of different frequencies. (3) The main body is a conversion unit interposed between a standard otoscope head and a standard battery handle, the unit characterized by circuit means for generating tones of different frequencies. The otoscope and audiometer described in section. 4. An otoscope and audiometer according to claim 1, including means within the body for generating tones of different intensities. (5) A visible passage passing through the head and the otoscope is removable to always close the opening at the outer end of the otoscope, the opening provided on the side of the head opposite to the otoscope, and the opening in the head. An otoscope and audiometer according to claim 1, including a sealing member, said sealing member including a lens and a frame. (6) The otoscope and audiometer according to claim 1, further comprising means provided at the outer end of the otoscope to seal between the otoscope and the auditory canal. (7) The otoscope and audiometer according to claim 1, further comprising means provided on the main body for visually indicating when each tone is sent to the head. 8. An otoscope and audiometer according to claim 1, wherein the means for generating tones of different frequencies is an electronic circuit, the circuit including timing means for accurately controlling the duration of each tone. (9) The otoscope and audiometer according to claim 8, wherein the electronic circuit is in the form of a removable and replaceable module. (10) an elongated main body consisting of two mating parts;
a head having an integral otoscope, the head and the otoscope having an unobstructed visible path therethrough from an outer end of the otoscope to an opening in a side of the head opposite the otoscope; further comprising a removable sealing member that permanently closes the head opening in a substantially airtight manner, a light source disposed within the head, and means for transmitting light from the light source outwardly toward the auditory canal under examination; circuit means provided within the main body for automatically generating tones of different frequencies in sequence; and means for sending the tones from the main body into the interior of the head and from there into the auditory canal through an otoscope; An otoscope and audiometer consisting of a stage mounted on the main body that visually indicates when each tone is generated by the circuit means. [alpha]1) The otoscope and audiometer according to claim 10, which includes means for generating a strong tone provided within the main body. α2 The otoscope and audiometer according to claim 10, further comprising means provided at the outer end of the otoscope to seal between the otoscope and the auditory canal. (13) The circuit means is a removable and replaceable module that is factory calibrated. The otoscope and audiometer according to claim 10, further comprising a start switch. Claim 10: The circuit means includes a battery for supplying power, and the circuit means further includes an undervoltage indicator and means for disabling the circuit when the battery voltage falls below a predetermined level. The otoscope and audiometer described in the section. (11, 9 circuits each) -7, lJ] l, top
11. An otoscope and audiometer according to claim 10, including timing means for determining the positive IN nifilJ tflll. (17) A main body consisting of two mating parts, a head containing an otoscope whose outer end is adapted to enter the auditory canal of a patient undergoing a hearing test, and an earpiece provided at the outer end of the otoscope. means for sealing between the speculum and the auditory canal; circuit means including a transducer disposed within the body for automatically generating tones of different frequencies in sequence; and means for transmitting the tones from the transducer to the outer end of the otoscope. A hand belt type audiometer consisting of. (18) An audiometer according to claim 17, including means disposed within the body for generating tones of different intensities. 18. The audiometer of claim 17, further comprising means for visually indicating when each tone is transmitted to the otoscope. 20. The audiometer of claim 17, wherein the circuit means includes timing means for precisely controlling the duration of each tone. Q◇ The audiometer of claim 17, wherein the circuit means is a calibrated module removably secured within the body. 18. The audiometer of claim 17, wherein the circuit means includes a start/restart switch for initiating the generation of the tone. (c) Claim 17 includes a battery for supplying power to the circuit means, and the circuit means includes a battery voltage deficiency indicator and means for inactivating the circuit when the battery voltage drops below a predetermined level. audiometer.